NCPA offers solutions to pharmaceutical waste in long-term care dispensing

ALEXANDRIA, Va. A group that represents that nation's independent pharmacies have provided recommendations for a new law that will change the monthly dispensing cycle of prescription drugs to long-term care facilities in an effort to reduce pharmaceutical waste.

In a letter sent to the Centers for Medicare and Medicaid Services, the National Community Pharmacists Association stated four recommendations that will ease the financial burden and logistical hardships that community pharmacies will face, NCPA said.

"Pharmacists share the important goal of reducing pharmaceutical waste," said Bruce  Roberts, NCPA EVP and CEO. "But CMS must address the real concerns independent community pharmacies have with proposed long-term care prescription drug dispensing changes. Without examining how effective more frequent dispensing will be, providing more resources in a prompt fashion, creating a workable transition time period, and exempting smaller and rural independent community pharmacies, the change will likely be very disruptive. This is an example where the law of unintended consequences can be anticipated well in advance. We hope CMS is prudent in the policy that is implemented."

The recommended changes include:

• Conduct a scientific study of the actual benefits of reducing dispensing cycles from a monthly to weekly basis, since NCPA contends pharmacies already incorporate numerous strategies to deal with unused prescription drugs that are paid for under Medicare Part D; and/or utilize an interim stage of reducing the dispensing window to every 14 days to ascertain its impact before moving forward with a tighter window, such as a seven-day cycle or less
• Allocate greater, timely financial compensation to help pharmacies adjust to the need to account for the extra dispensing cycles, which may entail, for example, hiring more staff or investing in additional technology.
• Create an exemption for small pharmacies (those meeting the Small Business Administration's definition as having revenues of $7 million or less) and those in rural areas that will likely lack the incentives or capital to continue providing long-term care services.
• Allow for a two-year transition for these changes to occur from Jan. 1, 2012 until Jan. 1, 2014 instead of having the earlier date be the line of demarcation for full compliance, so pharmacies can effectively implement the changes without too much disruption to their long-term care services.

"Approximately 7,000 independent community pharmacies service the long-term care market, but without a more common-sense approach to limiting pharmaceutical waste their participation levels might have to drop in order to maintain financial viability," added Roberts.